ID

5940

Beskrivning

IKDC 2000 Score modified from http://www.orthopaedicscores.com

Länk

http://www.orthopaedicscores.com

Nyckelord

Versioner (2)
  1. 2014-11-20 2014-11-20 - Martin Dugas
  2. 2014-11-20 2014-11-20 - Martin Dugas
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20 november 2014

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Creative Commons BY-NC 3.0 Legacy
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IKDC Subjective Knee Evaluation Form

Tysk Engelsk

IKDC Subjective Knee Evaluation Form

1 Formulär  
General information
Beskrivning

General information

Alias
UMLS CUI-1
C1508263
Patient name
Beskrivning

Patient name

Datatyp

text

Alias
UMLS CUI-1
C1299487
Date of birth
Beskrivning

Date of birth

Datatyp

date

Alias
UMLS CUI-1
C0421451
Clinician diagnosis
Beskrivning

Clinician diagnosis

Datatyp

text

Alias
UMLS CUI-1
C0011900
Type of surgery
Beskrivning

Type of surgery

Datatyp

text

Alias
UMLS CUI-1
C0543467
Surgery date
Beskrivning

Surgery date

Datatyp

date

Alias
UMLS CUI-1
C1628561
Symptoms
Beskrivning

Symptoms

Alias
UMLS CUI-1
C1457887
What is the highest level of activity that you can perform without significant knee pain? (last week)
Beskrivning

What is the highest level of activity that you can perform without significant knee pain? (last week)

Datatyp

integer

During the past 4 weeks, or since your injury, how often have you had pain?
Beskrivning

During the past 4 weeks, or since your injury, how often have you had pain?

Datatyp

integer

If you have pain, how severe is it?
Beskrivning

If you have pain, how severe is it?

Datatyp

integer

Alias
UMLS CUI-1
C1507013
During the past 4 weeks, or since your injury, how stiff or swollen was your knee?
Beskrivning

During the past 4 weeks, or since your injury, how stiff or swollen was your knee?

Datatyp

integer

Alias
UMLS CUI-1
C0576086
What is the highest level of activity you can perform without significant swelling in your knee?
Beskrivning

What is the highest level of activity you can perform without significant swelling in your knee?

Datatyp

integer

During the past 4 weeks, or since your injury, did your knee lock or catch?
Beskrivning

During the past 4 weeks, or since your injury, did your knee lock or catch?

Datatyp

boolean

Alias
UMLS CUI-1
C0231753
What is the highest level of activity you can perform without significant giving way in your knee?
Beskrivning

What is the highest level of activity you can perform without significant giving way in your knee?

Datatyp

integer

Sports activities
Beskrivning

Sports activities

Alias
UMLS CUI-1
C0038039
What is the highest level of activity you can participate in on a regular basis?
Beskrivning

What is the highest level of activity you can participate in on a regular basis?

Datatyp

integer

Alias
UMLS CUI-1
C3694575
How does your knee affect your ability to go up stairs?
Beskrivning

How does your knee affect your ability to go up stairs?

Datatyp

integer

How does your knee affect your ability to go down stairs?
Beskrivning

How does your knee affect your ability to go down stairs?

Datatyp

integer

How does your knee affect your ability to kneel on the front of your knee?
Beskrivning

How does your knee affect your ability to kneel on the front of your knee?

Datatyp

integer

How does your knee affect your ability to squat?
Beskrivning

How does your knee affect your ability to squat?

Datatyp

integer

Alias
UMLS CUI-1
C0560874
How does your knee affect your ability to sit with your knee bent?
Beskrivning

How does your knee affect your ability to sit with your knee bent?

Datatyp

integer

How does your knee affect your ability to rise from a chair?
Beskrivning

How does your knee affect your ability to rise from a chair?

Datatyp

integer

How does your knee affect your ability to run straight ahead?
Beskrivning

How does your knee affect your ability to run straight ahead?

Datatyp

integer

How does your knee affect your ability to jump and land on your involved leg?
Beskrivning

How does your knee affect your ability to jump and land on your involved leg?

Datatyp

integer

How does your knee affect your ability to stop and start quickly?
Beskrivning

How does your knee affect your ability to stop and start quickly?

Datatyp

integer

Function, and activity of daily living
Beskrivning

Function, and activity of daily living

Alias
UMLS CUI-1
C0001288
Function prior to knee injury?
Beskrivning

Function prior to knee injury: How would you rate the function of your knee on a scale of 0 to 10 with 10 being normal, excellent function and 0 being the inability to perform any of your usual daily activities which may include sports?

Datatyp

integer

Current function of your knee?
Beskrivning

Current function of your knee (last week): How would you rate the function of your knee on a scale of 0 to 10 with 10 being normal, excellent function and 0 being the inability to perform any of your usual daily activities which may include sports?

Datatyp

integer

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Similar models

IKDC Subjective Knee Evaluation Form

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
General information
C1508263 (UMLS CUI-1)
Patient name
Item
Patient name
text
C1299487 (UMLS CUI-1)
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI-1)
Clinician diagnosis
Item
Clinician diagnosis
text
C0011900 (UMLS CUI-1)
Type of surgery
Item
Type of surgery
text
C0543467 (UMLS CUI-1)
Surgery date
Item
Surgery date
date
C1628561 (UMLS CUI-1)
Item Group
Symptoms
C1457887 (UMLS CUI-1)
Item
What is the highest level of activity that you can perform without significant knee pain? (last week)
integer
Activity level without pain
Code List
What is the highest level of activity that you can perform without significant knee pain? (last week)
CL Item
Unable to perform any of the above activities due to knee pain (0)
CL Item
Very strenuous activities like jumping or pivoting as in basketball or soccer (4)
CL Item
Strenuous activities like heavy physical work, skiing or tennis (3)
CL Item
Moderate activities like moderate physical work, running or jogging (2)
CL Item
Light activities like walking, housework or yard work (1)
Item
During the past 4 weeks, or since your injury, how often have you had pain?
integer
pain during past 4 weeks
Code List
During the past 4 weeks, or since your injury, how often have you had pain?
CL Item
Never (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
Constant (10)
Item
If you have pain, how severe is it?
integer
C1507013 (UMLS CUI-1)
Pain severity
Code List
If you have pain, how severe is it?
CL Item
No Pain (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
Worst Pain (10)
Item
During the past 4 weeks, or since your injury, how stiff or swollen was your knee?
integer
C0576086 (UMLS CUI-1)
Swelling of knee joint
Code List
During the past 4 weeks, or since your injury, how stiff or swollen was your knee?
CL Item
Not at all (0)
CL Item
Mildly (1)
CL Item
Moderately (2)
CL Item
Very (3)
CL Item
Extremely (4)
Item
What is the highest level of activity you can perform without significant swelling in your knee?
integer
Activity level without swelling
Code List
What is the highest level of activity you can perform without significant swelling in your knee?
CL Item
Very strenuous activities like jumping or pivoting as in basketball or soccer (4)
CL Item
Strenuous activities like heavy physical work, skiing or tennis (3)
CL Item
Moderate activities like moderate physical work, running or jogging (2)
CL Item
Light activities like walking, housework, or yard work (1)
CL Item
Unable to perform any of the above activities due to knee swelling (0)
Knee locking
Item
During the past 4 weeks, or since your injury, did your knee lock or catch?
boolean
C0231753 (UMLS CUI-1)
Item
What is the highest level of activity you can perform without significant giving way in your knee?
integer
Activity level without giving way in knee
Code List
What is the highest level of activity you can perform without significant giving way in your knee?
CL Item
Very strenuous activities like jumping or pivoting as in basketball or soccer (4)
CL Item
Strenuous activities like heavy physical work, skiing or tennis (3)
CL Item
Moderate activities like moderate physical work, running or jogging (2)
CL Item
Light activities like walking, housework or yard work (1)
CL Item
Unable to perform any of the above activities due to giving way of the knee (0)
Item Group
Sports activities
C0038039 (UMLS CUI-1)
Item
What is the highest level of activity you can participate in on a regular basis?
integer
C3694575 (UMLS CUI-1)
Physical activity level
Code List
What is the highest level of activity you can participate in on a regular basis?
CL Item
Very strenuous activities like jumping or pivoting as in basketball or soccer (4)
CL Item
Strenuous activities like heavy physical work, skiing or tennis (3)
CL Item
Moderate activities like moderate physical work, running or jogging (2)
CL Item
Light activities like walking, housework or yard work (1)
CL Item
Unable to perform any of the above activities due to giving way of the knee (0)
Item
How does your knee affect your ability to go up stairs?
integer
Go up stairs
Code List
How does your knee affect your ability to go up stairs?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to go down stairs?
integer
Go down stairs
Code List
How does your knee affect your ability to go down stairs?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to kneel on the front of your knee?
integer
Kneel on the front of your knee
Code List
How does your knee affect your ability to kneel on the front of your knee?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to squat?
integer
C0560874 (UMLS CUI-1)
Ability to squat
Code List
How does your knee affect your ability to squat?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to sit with your knee bent?
integer
Sit with knee bent
Code List
How does your knee affect your ability to sit with your knee bent?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to rise from a chair?
integer
Rise from a chair
Code List
How does your knee affect your ability to rise from a chair?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to run straight ahead?
integer
Run straight ahead
Code List
How does your knee affect your ability to run straight ahead?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to jump and land on your involved leg?
integer
Jump and land on your involved leg
Code List
How does your knee affect your ability to jump and land on your involved leg?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item
How does your knee affect your ability to stop and start quickly?
integer
Stop and start quickly
Code List
How does your knee affect your ability to stop and start quickly?
CL Item
No difficulty  (4)
CL Item
Minimal difficulty (3)
CL Item
Moderate difficulty (2)
CL Item
Extreme difficulty (1)
CL Item
Unable to do (0)
Item Group
Function, and activity of daily living
C0001288 (UMLS CUI-1)
Item
Function prior to knee injury?
integer
Function prior to knee injury
Code List
Function prior to knee injury?
CL Item
Can not perform ADL (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
No limitation of ADL (10)
Item
Current function of your knee?
integer
Current function of your knee
Code List
Current function of your knee?
CL Item
Can not perform ADL (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
No limitation of ADL (10)
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